CONVENTIONAL OR LAPAROSCOPIC CHOLECYSTECT OMY IN THE TREATMENT OF ACUTE CHOLECYSTITIS

Elective laparoscopic cholecystectomy has become established as the pr ocedure of choice for the treatment of symptomatic cholecystolithiasis while the application of this method for acute cholecystitis has been propagated with restrainment. In a prospective study 114 conventional (right subcostal incision) and 102 laparoscopic cholecystectomies for this indication were compared. The overall complication rate amounted 10.7% for conventional cholecystectomy and 8.9% for laparoscopic chol ecystectomy. The rate of conversion was 9.2%. Due to the fact that int raoperative cholangiography was carried out in 60% of conventional cho lecystectomies and in only one of laparoscopic procedures the arithmet ic advantage of minimally invasive technique with respect to blood los s and operating time does not allow final conclusions. These patients however recovered clearly faster and could be discharged after an aver age of 5.2 +/- 4.2 postoperative days, while the hospitalisation after conventional operations amounted to 7.6 +/- 3.8 days (p < 0.001).